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ORIGINAL ARTICLE  RECENT ADVANCES IN THE MANAGEMENT OF AORTIC ARCH DISEASE 

The Journal of Cardiovascular Surgery 2018 August;59(4):547-53

DOI: 10.23736/S0021-9509.18.10410-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Endovascular repair of aortic arch disease with double inner branched thoracic stent graft: the Bolton perspective

Ciro FERRER 1, Carlo COSCARELLA 2, Piergiorgio CAO 3

1 Unit of Vascular Surgery, Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Rome, Italy; 2 Vascular and Endovascular Surgery Unit, San Giovanni Addolorata Hospital, Rome, Italy; 3 Mater Dei Hospital, Rome, Italy


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BACKGROUND: In the light of current evidence, endovascular repair of aortic arch pathologies with custom-made devices should be considered a valid alternative to decrease operative mortality and morbidity associated with open or hybrid repair. Today, two double inner branch devices are available on market. We report our single-center experience with Bolton double branch stent graft in the treatment of aortic arch disease.
METHODS: Between 2013 and 2016, 15 high-risk patients with arch pathology were treated in our center with a custom-made branched device. Six of these received a Cook arch branched stent graft. Nine were treated with Bolton device. Among these, 2 with single branch model were excluded leaving a subgroup of 7 patients object of this study.
RESULTS: Out of the 7 male patients (mean age 76, range 70-85) included in the study, 2 died in-hospital after stroke and retrograde dissection, respectively. No other death, major complication or secondary intervention was recorded at a mean follow-up of 24 (min-max 6-53) months, neither any aneurysmal diameter evolution nor branch related complications.
CONCLUSIONS: Despite the small sample size, our results are in line with the early-published experiences about this technique. Endovascular repair of aortic arch disease with custom-made branched devices should always be considered to give high-risk patients a chance of repair.


KEY WORDS: Aortic arch syndromes - Stents - Endovascular procedures

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